Provider Demographics
NPI:1972840809
Name:MARTINEZ, ANA ISABEL
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ISABEL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 BRADFORD WAY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7640
Mailing Address - Country:US
Mailing Address - Phone:405-265-0342
Mailing Address - Fax:
Practice Address - Street 1:10100 BRADFORD WAY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7640
Practice Address - Country:US
Practice Address - Phone:405-265-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health